FORM ID: CDS/FORM/02A APPLICATION TO OPEN A CDS SECURITIES ACCOUNT (To be submitted in duplicate and delivered to the Manager Domestic Markets) Manager Domestic Markets Bank of Tanzania P.O. Box 2939 Date:.. Dar es Salaam I / We hereby apply to open a CDS securities account with the following details which I/We confirm to be correct. 1. APPLICANTS DETAILS SOLE HOLDER S ACCOUNT DETAILS NAME OF ACCOUNT CDS ID (if exists) A Postal Address B Physical Address C Telephone D Fax E E-mail F Tax Identification Number G Nationality H Country of Residence I Company Registration Number J Tax Status (If exempted provide evidence) Additional Information for Individuals K Passport # & Place of Issue Expiry Date (DD-MM-YYYY) L Voter ID # M Driving License # N National ID # O Occupation P Employer Q Employment ID # R Date of Birth (DD-MM-YYYY) S Mobile No. Not Exempt Exempt 2. SETTLEMENT BANK DETAILS BANK DETAILS A Bank Name B Branch Name C Account No.* D Name of Account* E Address F Telephone G Fax H E-mail *NB: Name of Bank Account shall correspond with CDS Account Name
3. PERSONS AUTHORIZED TO OPERATE THE CDS SECURITIES ACCOUNT A B C D NAME OF AUTHORIZED SIGNATORY Surname First name Middle name SPECIMEN SIGNATURE 4. CATEGORY OF THE CDS SECURITIES ACCOUNT HOLDER Please use the category of the account holder indicated as annex of this application (annex to CDS form 2) that best describes the applicant to complete this section. Category of Account Holder Class 5. MANDATE FOR OPERATING CDS SECURITY ACCOUNT I / We hereby agree to operate a CDS securities account in accordance with the rules prescribed in the Central Depository System Dealing Agreement and the Central Depository System Rules and Operational Guidelines; and request you to honor any instructions bearing signature(s) provided above (and on your specimen signature cards). Authorized Signature Authorized Signature
Category of Account holder Annex to CDS Form 2 Account Holder Categories Information Sheet Class 1. Bank of Tanzania BOT Open Market Operations BOT Special Funds 2. Government Agencies Central Government Government of Zanzibar Local Governments Parastatals 3. Banks Non-Banks Financial Institution Regional Banks Community Banks Deposit Money Banks 4. Trust Companies Pensions Funds Provident Funds Unit Trust Social Security Regulatory Authority 5. Insurance Companies Commissioner of Insurance Insurance Company Insurance Broker 6. Other Financial Institutions Credit Institution Bureau De Change 7. Market Intermediaries Authorized Dealer Capital Markets and Securities Authority Dar es salaam Stock Exchange Mortgage Finance Company Broker 8. Individuals Individual Joint Minor 9. Others Manufacturing Firm Commercial Enterprise Non-Government Organization (NGO) Social Group Religious Group Educational Group Micro-Finance Institution Co-operative Other Official Entities Medical Health Schemes Professional Organization Health Institution
Attachment to CDS Form 02 SPECIMEN SIGNATURE CARD (To be submitted in duplicate and delivered to the Manager Domestic Markets) PHOTOGRAPH 1 PHOTOGRAPH 2 Manager Domestic Markets Bank of Tanzania Date:. I the undersigned hereby request to open a CDS securities account in the name.. Address Telephone... Fax.. Email.... I/ We hereunder agree to conform to the rules governing the CDS securities account within the Central Depository System Dealing Service. The specimen signature(s) for person(s) who may be given the mandate to sign on my behalf are: SIGNATORIES: FULL NAME SIGNATURE PHOTOGRAPH 3 1. 2. 3. 4. The specimen card is returned herewith by the applicant of the CDS securities account indicated on CDS Form 02 Yours faithfully, (Full Name) PHOTOGRAPH 4. (Signature)
For Central Depository Participant Official Use Only Originated By: Sign Date Verified By: Sign Date Approved By: Sign Date Central Depository Participant CDS ID: Central Depository Participant CDS SEC. A/C:.. Remarks: